Studies Question the Use of Herbs for Menopause Relief

As women seek natural alternatives to hormone replacement therapy to relieve menopausal symptoms, Western medicine has shown an increasing interest in investigating what once were termed "folk" remedies. A few, particularly soy, have shown promise in relieving some symptoms. However, hormone replacement therapy remains the current treatment standard because of its effectiveness.

Dong Quai

In Chinese medicine, the root of the angelica sinesis plant is known as Dong Quai. In China, it is used for painful or difficult menstruation, anemia or abdominal pain and as a supportive herb for menopausal symptoms. But in traditional Chinese medicine, it is never used alone. It has gained an identity in the West as the "menopause herb," but this reputation is not supported by scientific evidence.

A recent double-blind study of 71 post-menopausal women with significant menopausal symptoms received either a placebo or 1500mg of Dong Quai extract three times a day. (During the course of a double-blind study, neither patients nor researchers know who is receiving a placebo of inactive ingredients or who is receiving the substance being tested.) The study found no change in the proliferation of endometrial cells lining the uterus or hormone blood levels -- both key menopausal measures. Dong Quai contains coumarin derivatives, which slow blood clotting, particularly in patients taking the blood thinner coumadin. Dong Quai may also cause sensitivity to the sun and skin rashes. It should not be used during pregnancy.

Red Clover

Red clover (trifolium pratense) has been used in America to treat a variety of conditions for more than a century. Only recently has it been marketed specifically to treat menopausal symptoms. Promensil may be the most well known brand.

Red clover contains phytoestrogens, hormone-like substances found in some plants, including soy. Two double-blind studies, both funded by the manufacturer of Promensil, found no difference between red clover and a placebo for treating menopausal symptoms such as hot flashes and vaginal dryness. The studies tested daily doses of 40mg or 60mg of red clover administered for 12 weeks.

However, another study found that red clover may increase blood flow in arteries, which diminishes with menopause. Patients were given 40mg of red clover for five weeks followed by 80mg for five weeks. Note that red clover may stimulate breast cancer cells. It also contains coumarin.

Vitamin E

Current data does not support the use of vitamin E for menopausal symptoms. A study by the North Central Cancer Treatment Group included 125 women with a history of breast cancer who each experienced at least 14 hot flashes per week. They received 400 international units of vitamin E twice daily for four weeks. The study found that vitamin E reduced hot flashes only slightly more than a placebo.

Wild Yam

Progesterone creams contains diosgenin, which is synthetically derived from wild yams and is identical to human progesterone. There have been some reports that progesterone cream might increase bone mineral density (BMD) of the lumbar spine and provide a sense of well-being. A recent double-blind study of progesterone cream found improvement or resolution of hot flashes in 83% of women compared to 19% on placebo. Women in the study applied 1/4 teaspoon of the cream containing 20mg of progesterone once a day. However, there was no effect on BMD or depression scores. Of 102 post-menopausal women in the study, eight experienced vaginal spotting.

Finally, consumers should keep in mind that remedies labeled as "natural" are not necessarily safe. The use of certain herbs and other natural substances can be toxic or, in rare cases, even deadly. Be sure to discuss the use of herbs and supplements with your physician.

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.